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THIA HASELTON
NPI 1780746495
Marriage & Family Therapist in San Rafael, CA

Active since December 16, 2006PECOS EnrolledAccepts Medicare Assignment
1826 5TH AVE, SAN RAFAEL, CA 94901(415) 299-7958(628) 201-6698 Get Directions Write a Review

NPPES record last updated: January 5, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Thia Haselton NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THIA HASELTON (NPI 1780746495) is an individual marriage & family therapist in San Rafael, California, licensed in California (MFT 40276) and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1992).

NPPES Registry Identity

NPI1780746495
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameTHIA HASELTON
Location Address1826 5TH AVESan Rafael, CA 94901-1710
Mailing Address1826 5th AveSan Rafael, CA 94901-1710 · (415) 299-7958 · Fax (628) 201-6698
Phone(415) 299-7958
Fax(628) 201-6698
Sole ProprietorYes
Medical School CMSOtherGraduated 1992
Enumeration DateDecember 16, 2006
Last NPPES UpdateJanuary 5, 2026
NPPES CertifiedJanuary 5, 2026
✔ NPI 1780746495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in CA · MFT 40276
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
1826 5TH AVE, San Rafael, CA 94901
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Thia Haselton is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3375008345
PECOS Enrollment IDI20260720004397
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Thia Haselton reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Shine Medical Of Ca PC
57 mi
Psychiatry
325 S 1ST ST STE 200
San Jose, CA 95113
  • Reassigned Medicare billing, California enrollment
  • 45 clinicians in this Medicare group
NPI 1942935473 (888) 380-2028

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Thia Haselton's NPI number?

The NPI number for Thia Haselton is 1780746495. It was assigned to this individual provider in the NPPES registry on December 16, 2006.

Where is Thia Haselton located?

Thia Haselton practices at 1826 5th Ave, San Rafael, CA 94901. The listed phone number is (415) 299-7958.

What is Thia Haselton's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Thia Haselton enrolled in Medicare?

Yes. Thia Haselton is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Thia Haselton's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Thia Haselton reassigns Medicare benefits to Shine Medical Of Ca PC (San Jose, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Thia Haselton's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Thia Haselton was last updated on January 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.